Analysis of hospital costs for robotic and open pancreatectomy incurred during the implementation of a robotic pancreatectomy program at a cancer center

Background

Costs associated with robotic pancreatectomy compared to those of open pancreatectomy are assumed to be high but are not well known, particularly during the initial implementation of the robot.

Study Design

Patients who underwent pancreatectomy for any diagnosis from January 2017 to August 2021 were identified retrospectively. Total hospital cost was calculated using intraoperative, inpatient, and outpatient costs within 30 days of surgery. The ratio of the total cost of each pancreatectomy to the average cost of all operations at our center was used to represent cost without sharing proprietary financial data. Propensity score matching was performed to account for significant differences between the two groups.

Results

We identified 679 patients who underwent pancreatectomies, 88 of which were robotic. After propensity score matching, the open cohort had 176 patients, and the robotic cohort remained at 88 patients. The median hospital length of stay was 2 days shorter for robotic than for open pancreatectomy (p < 0.001). The total hospital cost was markedly lower in the robotic pancreatectomy cohort. The inpatient and outpatient costs for robotic pancreatectomy were considerably lower than those for open pancreatectomy despite substantially higher intraoperative costs for the former procedure. A scatter plot of total costs after the initial adoption of the robot showed a trend of decreasing costs over time.

Conclusion

Overall, total hospital costs associated with robotic pancreatectomy were lower than those for open surgery, mainly driven by shorter length of stay. Our findings suggest that costs of robotic pancreatectomy may decrease further with increased surgeon experience.